NPI | 1346247673 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OH DC.1699) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MI 2301005740) |
Enumeration Date | 2005-07-01 |
Last Update Date | 2013-07-25 |