NPI | 1780758466 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00002227) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MI 2301006668) |
111N00000X Chiropractor (Licence: WI 2305-012) | |
Enumeration Date | 2006-11-17 |
Last Update Date | 2007-07-09 |