NPI | 1962572883 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X004397-1) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 003463-1) |
Enumeration Date | 2006-11-08 |
Last Update Date | 2011-03-25 |