| NPI | 1073330676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: LA 2019) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: LA 2019) |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |