| NPI | 1851538631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC004861L) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA AK000651) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2017-01-14 |