NPI | 1861575961 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA434) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: ID ACC79) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2010-09-28 |