| NPI | 1851332324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00207600) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00006300) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2008-06-12 |