| NPI | 1316267552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC010443) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9952) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2011-10-06 |