NPI | 1598760696 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ MC01755) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: DE F10000166) |
111N00000X Chiropractor (Licence: PA DC006478R) | |
111N00000X Chiropractor (Licence: SC 2759) | |
Enumeration Date | 2005-06-15 |
Last Update Date | 2008-08-21 |