NPI | 1336241785 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 1429) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: ND 724) |
Enumeration Date | 2006-09-05 |
Last Update Date | 2010-07-28 |