NPI | 1568472454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F10000574) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY x00004739-1) |
171100000X Acupuncturist (Licence: NY 000634-1) | |
Enumeration Date | 2006-08-09 |
Last Update Date | 2010-07-20 |