NPI | 1437452851 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: VT 006.0079419) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IA 007379) |
Enumeration Date | 2010-12-07 |
Last Update Date | 2011-07-19 |