NPI | 1952347320 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 2277) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 3095) |
Enumeration Date | 2006-06-22 |
Last Update Date | 2007-07-08 |