| NPI | 1366437295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC-007735-L) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA AJ-007735-L) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2026-07-16 |