| NPI | 1689728933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: NY x006698) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: PA DC004725L) |
| 111NN0400X Chiropractor, Neurology (Licence: NJ 38mc00592400) | |
| 111NN0400X Chiropractor, Neurology (Licence: CT 000967) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-08 |