NPI | 1740233949 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 26721) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: SC 2566) |
Enumeration Date | 2006-05-18 |
Last Update Date | 2010-11-11 |