NPI | 1407097173 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: TX 9740) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: TX 9740) |
Enumeration Date | 2009-03-10 |
Last Update Date | 2009-03-10 |