| NPI | 1841422268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 011661) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38mc000673800) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2010-06-28 |