NPI | 1992821078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: SC 3661) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MI L766087) |
Enumeration Date | 2007-03-21 |
Last Update Date | 2011-09-29 |