NPI | 1801180740 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225000000X Orthotic Fitter (Licence: NJ C53544) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ mc03636) |
Enumeration Date | 2011-06-08 |
Last Update Date | 2024-02-11 |