| NPI | 1184751869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 4093) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC009764) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2016-11-23 |