| NPI | 1285921833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC010614) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA CH10298) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2012-06-28 |