NPI | 1659307783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 10453) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MI KM009200) |
Enumeration Date | 2006-06-23 |
Last Update Date | 2007-07-08 |