NPI | 1679723878 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X011725) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00675600) |
Enumeration Date | 2008-09-24 |
Last Update Date | 2009-07-22 |