NPI | 1770709461 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 3272) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 3258) |
Enumeration Date | 2007-04-18 |
Last Update Date | 2007-07-08 |