| NPI | 1356595573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 1377) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL ch6485) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2008-11-14 |