| NPI | 1801065016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NI0013X Chiropractor Independent Medical Examiner (Licence: NY NYSIMEC042582B) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X0042581) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2008-02-22 |