NPI | 1013297217 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR008877) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 6699) |
Enumeration Date | 2011-08-19 |
Last Update Date | 2024-07-25 |