NPI | 1881790905 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F10000978) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY 010220) |
Enumeration Date | 2006-09-15 |
Last Update Date | 2024-04-04 |