NPI | 1851315204 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OH DC1373) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: WV 480) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2013-08-14 |