NPI | 1295861144 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR008572) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 8624) |
Enumeration Date | 2007-02-26 |
Last Update Date | 2015-07-29 |