| NPI | 1891861845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0200X Chiropractor, Radiology (Licence: FL CH7981) |
| Additional Taxonomies | 111NR0200X Chiropractor, Radiology (Licence: NY X008063-1) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-08 |