NPI | 1093820433 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CT 001313) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X-005230-1) |
Enumeration Date | 2006-08-19 |
Last Update Date | 2014-05-20 |