| NPI | 1407926884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: RI DCP00601) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: IL 038007551) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2012-07-10 |