NPI | 1396856183 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 1089) |
Additional Taxonomies | 111NX0800X Chiropractor, Orthopedic (Licence: AL 2317) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2007-07-08 |