NPI | 1952470478 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ MC002703) |
Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: NJ MC002703) |
Enumeration Date | 2006-11-07 |
Last Update Date | 2007-07-08 |