| NPI | 1346227220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor Orthopedic (Licence: NJ 38MC00299200) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00006500) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2019-05-15 |