NPI | 1720108947 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 15633CA) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 2785) |
111N00000X Chiropractor (Licence: CA 15633DC) | |
Enumeration Date | 2007-03-30 |
Last Update Date | 2009-03-20 |