NPI | 1194585448 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 013825) |
Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: NY x013825) |
Enumeration Date | 2024-03-21 |
Last Update Date | 2025-04-06 |