| NPI | 1538360581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY x008703-1) |
| 111N00000X Chiropractor (Licence: NJ 38mc00581900) | |
| 174400000X Specialist | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2023-05-09 |