| NPI | 1932440401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CT 1933) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00707200) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2024-07-23 |