NPI | 1942241096 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TN DC0000002203) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038010621) |
Enumeration Date | 2006-06-09 |
Last Update Date | 2010-09-29 |