NPI | 1467792044 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: UT 8547239-1202) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2013002496) |
Enumeration Date | 2013-02-19 |
Last Update Date | 2013-03-14 |