| NPI | 1942371349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VT 610) |
| Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: VT 610) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2008-05-16 |