| NPI | 1992744320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC008795) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH7656) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2023-12-20 |