| NPI | 1669683785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC011909) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00034412) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2025-03-11 |