NPI | 1881779429 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 04891) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NE 781) |
Enumeration Date | 2006-10-25 |
Last Update Date | 2007-07-09 |