NPI | 1700854999 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NM 1653) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC-26357) |
Enumeration Date | 2006-03-14 |
Last Update Date | 2007-07-23 |