NPI | 1699823070 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08001879A) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MI 2301007973) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2007-07-08 |