| NPI | 1518046457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X007082-1) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X007082) |
| 111N00000X Chiropractor (Licence: NY X007082-3) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2015-12-14 |