| NPI | 1447268438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104000967) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0104000967) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2011-09-15 |