NPI | 1902846835 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00106300) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: SC 2234) |
Enumeration Date | 2006-06-08 |
Last Update Date | 2007-07-08 |