| NPI | 1144424599 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 2152) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY 2822) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2021-05-14 |