| NPI | 1396802294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X (Licence: DE F1-0000606) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: DE F10000606) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2018-03-13 |