NPI | 1346227030 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NC 1669) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 19323) |
111N00000X Chiropractor (Licence: TX 4713) | |
111N00000X Chiropractor (Licence: MI 6666) | |
Enumeration Date | 2005-12-23 |
Last Update Date | 2007-07-08 |