| NPI | 1669541421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC-005665-L) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC005665L) |
| 111N00000X Chiropractor (Licence: PA AJ005665L) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2009-02-10 |