NPI | 1770509929 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MS 1079) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TN 1999) |
Enumeration Date | 2006-07-14 |
Last Update Date | 2009-10-30 |