NPI | 1275696668 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 14640) |
Additional Taxonomies | 111NX0800X Chiropractor, Orthopedic (Licence: CA 14640) |
Enumeration Date | 2006-12-18 |
Last Update Date | 2007-07-08 |