| NPI | 1497116446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC011415) |
| Additional Taxonomies | 111NI0900X Chiropractor, Internist (Licence: FL CH11784) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2019-02-24 |