NPI | 1831192715 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MO CE-006306) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 4298) |
Enumeration Date | 2005-05-24 |
Last Update Date | 2012-12-21 |