| NPI | 1235361429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 012201) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00709300) |
| 175F00000X Naturopath (Licence: NH 131) | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2020-03-06 |