NPI | 1437142486 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 3327) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: ND 575) |
Enumeration Date | 2005-08-24 |
Last Update Date | 2019-09-05 |