| NPI | 1952403594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X2058) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 1016) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2010-10-08 |