NPI | 1528257953 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MD S01397) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD S01397) |
Enumeration Date | 2007-10-22 |
Last Update Date | 2015-09-22 |