| NPI | 1740250349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC-008956) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: PA AJ-008808) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2024-10-01 |