| NPI | 1750175675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: NJ 38MC00812400) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00812400) |
| 111NR0400X Chiropractor, Rehabilitation (Licence: NJ 38MC00812400) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: NJ 38MC00812400) | |
| 133N00000X Nutritionist | |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-04-07 |