NPI | 1891812152 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X006163) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CT 000872) |
Enumeration Date | 2007-03-23 |
Last Update Date | 2020-05-12 |