NPI | 1962513077 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AR 937) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: OK 2102) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2011-01-12 |