NPI | 1396875852 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 007072) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: AZ 7581) |
Enumeration Date | 2007-03-06 |
Last Update Date | 2008-07-18 |