NPI | 1679830335 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 012666) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 32273) |
Enumeration Date | 2012-04-19 |
Last Update Date | 2016-03-03 |