| NPI | 1265556575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MD 03490) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: DC CH030056) |
| 111N00000X Chiropractor (Licence: VA 0104556389) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |