NPI | 1356372767 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 162-340-009) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2004008742) |
111N00000X Chiropractor (Licence: NY X010879) | |
Enumeration Date | 2006-07-05 |
Last Update Date | 2010-02-04 |