| NPI | 1497852032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: NJ 38MC00248300) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00010100) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2007-09-24 |