NPI | 1871708164 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 3517) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: PR 297) |
Enumeration Date | 2007-05-11 |
Last Update Date | 2007-07-08 |