NPI | 1316120454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 3877) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 3754) |
111N00000X Chiropractor (Licence: IN 08002378A) | |
Enumeration Date | 2007-12-12 |
Last Update Date | 2008-04-14 |