NPI | 1457595605 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 011750) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 31457) |
111N00000X Chiropractor (Licence: NJ 38MC00737400) | |
Enumeration Date | 2009-04-30 |
Last Update Date | 2017-01-31 |