NPI | 1992836621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 4454-1) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X004454-1) |
Enumeration Date | 2007-03-07 |
Last Update Date | 2024-09-14 |