NPI | 1871898163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2301009844) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: KY 5269) |
Enumeration Date | 2011-01-18 |
Last Update Date | 2012-12-28 |