NPI | 1346450202 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: NJ 38MC00571900) |
Additional Taxonomies | 111NR0400X (Licence: NC 38MC00571900) |
111NS0005X Chiropractor, Sports Physician (Licence: NJ 38MC00571900) | |
Enumeration Date | 2007-05-22 |
Last Update Date | 2007-07-08 |