| NPI | 1164442380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA dc008838) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA dc00838) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2008-09-09 |