| NPI | 1437274305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CT 345) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 2213) |
| 111N00000X Chiropractor (Licence: NY 3213) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2007-07-08 |