| NPI | 1013118132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00450900) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2013-02-14 |