| NPI | 1437295573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC009218) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH13190) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2024-10-10 |