NPI | 1457340242 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC115120) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC11512) |
Enumeration Date | 2005-10-14 |
Last Update Date | 2008-11-04 |