| NPI | 1194757286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: NY 11944) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH-11611) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-07-21 |