| NPI | 1043465529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00258800) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00064800) |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2008-11-25 |