NPI | 1669577649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F10000284) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC005113L) |
111N00000X Chiropractor (Licence: NJ 38MC00397900) | |
Enumeration Date | 2006-09-14 |
Last Update Date | 2007-07-08 |