NPI | 1710199898 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: PA DC-008001-L) |
Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: PA ADJ-008001-L) |
Enumeration Date | 2007-05-03 |
Last Update Date | 2007-07-08 |