| NPI | 1861568537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00333200) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH13962) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2024-03-13 |