| NPI | 1649414814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: DE F1-0000732) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: DE F1-0000732) |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2015-06-09 |