| NPI | 1427767417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC011781) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC11781) |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2022-11-17 |