| NPI | 1073838991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: NJ 38MC00673900) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: NY X0116921) |
| Enumeration Date | 2010-04-03 |
| Last Update Date | 2020-05-04 |