| NPI | 1437300670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X010272) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY 010272) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2024-11-05 |