NPI | 1295898898 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00427700) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X0094791) |
Enumeration Date | 2006-12-18 |
Last Update Date | 2010-10-25 |