| NPI | 1073605556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X010568-1) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2013-04-22 |