NPI | 1649341264 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 2220) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2004011261) |
Enumeration Date | 2006-11-13 |
Last Update Date | 2013-02-13 |