NPI | 1396812947 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 7138) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 3826) |
Enumeration Date | 2006-11-29 |
Last Update Date | 2007-07-08 |