NPI | 1770610933 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 1089) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MI 2301005707) |
Enumeration Date | 2007-02-27 |
Last Update Date | 2007-07-08 |