NPI | 1518994904 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 5037) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 21930) |
Enumeration Date | 2006-06-28 |
Last Update Date | 2007-07-08 |