NPI | 1629250972 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 007040) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: KS T-01679) |
Enumeration Date | 2007-11-28 |
Last Update Date | 2008-07-31 |