| NPI | 1316274285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC010295) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC-31451) |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2013-12-06 |