| NPI | 1245577998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CT 1931) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: CT 1485) |
| 111N00000X Chiropractor (Licence: NY 012297) | |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2016-12-02 |