NPI | 1932200375 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC009968) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: OH OH3663) |
Enumeration Date | 2006-09-26 |
Last Update Date | 2016-03-07 |