| NPI | 1982838710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KS 01-06224) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC010079) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2022-12-21 |