| NPI | 1477641678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104555957) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MD 02054) |
| 111N00000X Chiropractor (Licence: DC CH030048) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2025-08-19 |