NPI | 1326023169 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00479000) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY XO11238-1) |
Enumeration Date | 2005-12-14 |
Last Update Date | 2007-07-08 |