| NPI | 1497723274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104001325) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0104001325) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2024-02-05 |