NPI | 1326008079 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NV B00949) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NV B00949) |
111NN1001X Chiropractor, Nutrition (Licence: NV B00949) | |
Enumeration Date | 2006-03-26 |
Last Update Date | 2013-09-17 |