NPI | 1669464608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 972) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL 4234) |
Enumeration Date | 2005-08-16 |
Last Update Date | 2010-05-17 |