NPI | 1891797411 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X010033) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ MC005753) |
111N00000X Chiropractor (Licence: FL CH8904) | |
Enumeration Date | 2005-08-12 |
Last Update Date | 2007-07-08 |