| NPI | 1538355920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: 1784) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00660100) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2013-04-16 |