| NPI | 1346393220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ mc04140) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00008500) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2023-10-30 |