NPI | 1194175331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 012849) |
Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: NY 012849) |
111NR0400X (Licence: NY 012849) | |
Enumeration Date | 2016-06-19 |
Last Update Date | 2024-02-27 |