| NPI | 1366519654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0100X Chiropractor, Occupational Health (Licence: PA DC003238-L) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC003238-L) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2025-09-11 |