| NPI | 1225114671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC005035L) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA AK001420) |
| 111N00000X Chiropractor (Licence: PA DC5035L) | |
| Enumeration Date | 2006-10-28 |
| Last Update Date | 2023-07-12 |