| NPI | 1720141344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104000430) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: DC CH15549) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2007-07-08 |