| NPI | 1184193807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: DC CH030194) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104557532) |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2018-11-26 |