| NPI | 1144338559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC009035) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00282700) |
| 111N00000X Chiropractor (Licence: NY X003744-1) | |
| Enumeration Date | 2006-08-26 |
| Last Update Date | 2008-12-02 |