| NPI | 1629037825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: PA DC003864L) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC003864L) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2014-09-16 |