| NPI | 1437145380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ15104800) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 778738) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP121902) | |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP033110) | |
| 111N00000X Chiropractor (Licence: TX 8101) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2025-10-06 |