NPI | 1720421894 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NI0900X Chiropractor, Internist (Licence: MA 2858) |
Additional Taxonomies | 111NI0900X Chiropractor, Internist (Licence: RI DCP00392) |
Enumeration Date | 2013-04-09 |
Last Update Date | 2013-04-09 |