NPI | 1699094045 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00367600) |
Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other Electroneurodiagnostic |
Enumeration Date | 2010-05-25 |
Last Update Date | 2015-03-21 |