| NPI | 1831484559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MD S03675) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104556892) |
| 111N00000X Chiropractor (Licence: DC CH030106) | |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2016-11-23 |