| NPI | 1487050506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MD S03799) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: DC CH030122) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |