| NPI | 1447476981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL cH-11182) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC-007431-L) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2014-09-25 |