NPI | 1730131558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ mc05592) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ MC005592) |
Enumeration Date | 2006-05-17 |
Last Update Date | 2011-08-12 |