| NPI | 1285843953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00496600) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X008199) |
| 111N00000X Chiropractor (Licence: PA DC 006685 L) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-07-08 |