NPI | 1689627358 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X0028951) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00221700) |
Enumeration Date | 2006-05-17 |
Last Update Date | 2010-07-09 |