NPI | 1124776752 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00794100) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR010578) |
Enumeration Date | 2022-03-14 |
Last Update Date | 2024-03-26 |