| NPI | 1285866566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC010194) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR008523) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-11-18 |