| NPI | 1568842342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: SC 04751) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: GA CHIR009216) |
| 111NN0400X Chiropractor, Neurology (Licence: NJ 38MC00715200) | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2022-03-02 |