| NPI | 1447645536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 012652) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY 70012652) |
| 171100000X Acupuncturist (Licence: NY 25005776) | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2016-08-16 |