| NPI | 1568432177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC-007145-L) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: PA AJ-007145-L) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2016-03-30 |