NPI | 1144689324 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MA 3527) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00734100) |
Enumeration Date | 2016-02-17 |
Last Update Date | 2017-03-06 |