| NPI | 1841732906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PR 620) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00738600) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2024-11-25 |