NPI | 1316939580 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MA 3744) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X004209-1) |
111N00000X Chiropractor (Licence: FL CH11269) | |
111N00000X Chiropractor (Licence: NJ 38MC00284600) | |
Enumeration Date | 2005-08-15 |
Last Update Date | 2024-01-26 |