NPI | 1558416321 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: ME CR1139) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NV B01389) |
Enumeration Date | 2007-01-24 |
Last Update Date | 2013-09-09 |