| NPI | 1033503370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00698400) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X012568-1) |
| 171100000X Acupuncturist (Licence: NJ 25MZ00087400) | |
| 171100000X Acupuncturist (Licence: NY 005832-1) | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2021-02-20 |