NPI | 1821094970 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC26437) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E3961) |
Enumeration Date | 2005-06-23 |
Last Update Date | 2007-07-09 |