NPI | 1750427787 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MA 2221) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY 008644) |
Enumeration Date | 2007-01-29 |
Last Update Date | 2016-02-03 |