| NPI | 1902841778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104001275) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: DC CH21056) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2010-11-05 |