NPI | 1124160684 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC006911L) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC6911-L) |
Enumeration Date | 2007-02-13 |
Last Update Date | 2025-01-04 |