NPI | 1306199138 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MD SO3759) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104557002) |
Enumeration Date | 2012-10-17 |
Last Update Date | 2013-08-23 |