| NPI | 1336233188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00194000) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL ch9624) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2025-02-21 |