NPI | 1861428666 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MD S01494) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD S01494) |
Enumeration Date | 2006-06-23 |
Last Update Date | 2007-07-09 |