| NPI | 1548622483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104557307) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: DC CH030143) |
| Enumeration Date | 2016-03-21 |
| Last Update Date | 2020-02-15 |