Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath |
NPI | 1457719874 |
---|---|
Provider Name | Mr. David Shaman |
First Address | Ventnor City, NJ 08406-1746 |
Second Address | Ventnor City, NJ 08406-1746 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2016 |
Last Update Date | 29/01/2016 |