| NPI | 1396190872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104557315) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0121000817) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |