NPI | 1336153568 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AK 542) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 5785) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2012-02-07 |