| NPI | 1548410178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: DC CH030087) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X011406-1) |
| 111N00000X Chiropractor (Licence: MD S03535) | |
| 111N00000X Chiropractor (Licence: VA 0104556556) | |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2023-11-16 |