| NPI | 1588739718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X008341-1) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X008341) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2023-12-18 |