NPI | 1811007206 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AK 125980) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: AZ 7333) |
111N00000X Chiropractor (Licence: AK 123799) | |
Enumeration Date | 2006-08-30 |
Last Update Date | 2017-09-25 |