NPI | 1962662247 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 3916) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 01-04563) |
Enumeration Date | 2008-06-11 |
Last Update Date | 2008-10-20 |