| NPI | 1730840257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: PA DC011560) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: DE F1-0011105) |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2023-08-29 |