NPI | 1235167842 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00593000) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2006-06-30 |
Last Update Date | 2012-01-30 |