NPI | 1407166010 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NV B01252) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NV B01252) |
111NN1001X Chiropractor, Nutrition (Licence: NV B01252) | |
Enumeration Date | 2010-10-15 |
Last Update Date | 2013-09-16 |