| NPI | 1477632248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F1-0000625) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC009507) |
| 111N00000X Chiropractor (Licence: NY X010790) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2013-11-25 |