NPI | 1659367431 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X006442-1) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ MC04052) |
Enumeration Date | 2005-09-27 |
Last Update Date | 2007-07-08 |