NPI | 1740320381 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MA 3117) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NH 780-0207) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2009-02-16 |