NPI | 1578650867 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B00691) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 19363) |
Enumeration Date | 2006-10-06 |
Last Update Date | 2016-10-20 |