NPI | 1891866075 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 8040) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 19914) |
Enumeration Date | 2006-11-10 |
Last Update Date | 2017-09-22 |