| NPI | 1487893293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: NY x009571-1) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: FL ch6846) |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2009-02-18 |