NPI | 1568616845 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X011383) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CT 001699) |
Enumeration Date | 2008-11-12 |
Last Update Date | 2008-12-10 |