NPI | 1346230059 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC14155) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MI 004511) |
Enumeration Date | 2005-10-24 |
Last Update Date | 2007-07-08 |