NPI | 1629180377 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F10000331) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC002769L) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2022-07-21 |