NPI | 1093852600 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CT 001819) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00620000) |
171100000X Acupuncturist | |
Enumeration Date | 2007-01-31 |
Last Update Date | 2019-09-27 |