NPI | 1023534518 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X012986-1) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00746300) |
Enumeration Date | 2017-08-17 |
Last Update Date | 2017-08-25 |