| NPI | 1427475680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104557141) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0104557141) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-09-17 |