NPI | 1790020097 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: CA 33346) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038012319) |
Enumeration Date | 2012-11-28 |
Last Update Date | 2016-02-16 |