| NPI | 1093798688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: FL 10019) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR007616) |
| 111N00000X Chiropractor (Licence: FL 10019) | |
| 111N00000X Chiropractor (Licence: CA 29781) | |
| 111NN0400X Chiropractor, Neurology (Licence: CA 29781) | |
| 111NN0400X Chiropractor, Neurology (Licence: GA 007616) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2010-10-20 |