| NPI | 1477606747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 1618) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH0002617) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2007-07-08 |