NPI | 1093995813 |
---|---|
Former Name | QUAY V PHUNG |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR008288) |
Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: GA CHIR008288) |
Enumeration Date | 2007-11-08 |
Last Update Date | 2007-11-08 |