NPI | 1548523111 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 007596) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CHR-6882) |
Enumeration Date | 2012-06-19 |
Last Update Date | 2013-02-19 |