| NPI | 1861616948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X002227-2) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 28-1322) |
| 111N00000X Chiropractor (Licence: CA 11888) | |
| 171100000X Acupuncturist (Licence: CA AC 4987) | |
| 171100000X Acupuncturist (Licence: MA 386) | |
| 171100000X Acupuncturist (Licence: NY 000395-1) | |
| 171100000X Acupuncturist (Licence: CT 000266) | |
| 171100000X Acupuncturist (Licence: NJ MZ 00118) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |