| NPI | 1033166707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: DE FI0000471) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC007651L) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2023-10-17 |