| NPI | 1376745927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: PA DC009912) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: NY 011287) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2008-02-12 |