| NPI | 1316198005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: DE F1-0000721) |
| Additional Taxonomies | 208D00000X General Practice (Licence: DE F1-0000721) |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2020-04-23 |