| NPI | 1740292481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00214000) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00054100) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2007-11-14 |