NPI | 1184738858 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00692600) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X011087) |
Enumeration Date | 2006-08-18 |
Last Update Date | 2011-10-11 |