NPI | 1750561114 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: LA 1462) |
Additional Taxonomies | 227800000X Respiratory Therapist, Certified (Licence: LA lt3700) |
Enumeration Date | 2007-11-13 |
Last Update Date | 2011-02-17 |