| NPI | 1447737770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 013064) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC011486) |
| 111N00000X Chiropractor (Licence: PR 718) | |
| 171100000X Acupuncturist (Licence: PA AK001304) | |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2022-11-04 |