| NPI | 1407254972 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 111N00000X Chiropractor (Licence: DC CH030169) | 
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038.012679) | 
| Enumeration Date | 2014-12-15 | 
| Last Update Date | 2022-07-21 |