| NPI | 1811949233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ MC004700) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X007695) |
| 111N00000X Chiropractor (Licence: FL CH8881) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-07-08 |