NPI | 1164573382 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 6768) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X006768) |
Enumeration Date | 2007-01-15 |
Last Update Date | 2024-02-28 |