NPI | 1548597651 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MT 1250) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC-31448) |
Enumeration Date | 2009-11-10 |
Last Update Date | 2016-05-10 |