| NPI | 1841255098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0100X Chiropractor, Occupational Health (Licence: PA AJ-009350) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC-009549) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2012-08-08 |