NPI | 1801286091 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC010991) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00724600) |
Enumeration Date | 2015-01-27 |
Last Update Date | 2024-04-30 |