NPI | 1821320409 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MD S03654) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MD 03654) |
Enumeration Date | 2010-02-05 |
Last Update Date | 2012-03-01 |