| NPI | 1720003254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC008928L) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC008928) |
| 111N00000X Chiropractor (Licence: PA AJ008928L) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-09-05 |