NPI | 1891762084 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 7691) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 01-03416) |
111N00000X Chiropractor (Licence: NE 644) | |
Enumeration Date | 2006-03-07 |
Last Update Date | 2007-07-09 |