| NPI | 1881613834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0200X Chiropractor, Radiology (Licence: NJ MC01802) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: NJ MC01802) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2025-09-11 |