NPI | 1366585861 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AK CHIC418) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: AK 0418) |
Enumeration Date | 2007-02-14 |
Last Update Date | 2019-09-25 |