| NPI | 1205091964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: DC CH030084) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MD 03559) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2010-08-05 |