NPI | 1326137563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: LA 1595) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 9514) |
Enumeration Date | 2006-10-12 |
Last Update Date | 2011-07-14 |