| NPI | 1356647556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NH 942) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38mc00698500) |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2014-11-06 |