| NPI | 1063853331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: DE f10000899) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: DE CQ-0000047) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2015-12-02 |