| NPI | 1881041499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F1-0000911) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104000911) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2017-07-18 |