| NPI | 1326182627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 009478) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 001520) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2012-06-13 |