NPI | 1962475368 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NC 1387) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: SC 2461) |
Enumeration Date | 2006-02-08 |
Last Update Date | 2007-08-29 |