| NPI | 1306158407 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 111N00000X Chiropractor (Licence: DC CH030095) | 
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104556773) | 
| Enumeration Date | 2010-07-07 | 
| Last Update Date | 2012-10-03 |