| NPI | 1679633978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC007851L) |
| Additional Taxonomies | 374K00000X |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2017-02-08 |