NPI | 1124224381 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00634600) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X011438) |
Enumeration Date | 2007-06-25 |
Last Update Date | 2021-09-16 |