| NPI | 1235164989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: NY x009838) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 004689) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-02-02 |