NPI | 1720262983 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00661600) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY 7011470) |
Enumeration Date | 2007-12-24 |
Last Update Date | 2023-09-13 |