| NPI | 1700953049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 3784) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL 4667) |
| 111N00000X Chiropractor (Licence: NJ 2639) | |
| 111N00000X Chiropractor (Licence: CT 522) | |
| 111N00000X Chiropractor (Licence: NH 7531205) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-08 |