NPI | 1346438355 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00727200) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC009820) |
Enumeration Date | 2007-10-04 |
Last Update Date | 2018-08-23 |