NPI | 1538268925 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F1-000368) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X007753-1) |
111N00000X Chiropractor (Licence: PA DC005512L) | |
Enumeration Date | 2006-09-21 |
Last Update Date | 2011-10-06 |