NPI | 1205949716 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00222600) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC002389L) |
111N00000X Chiropractor (Licence: NC 1339) | |
111N00000X Chiropractor (Licence: VA 0104000361) | |
111N00000X Chiropractor (Licence: MA 230989) | |
111N00000X Chiropractor (Licence: NY X003079-1) | |
Enumeration Date | 2006-08-17 |
Last Update Date | 2011-10-12 |