| NPI | 1881092351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MD S03820) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: DC CH30148) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2015-09-23 |