NPI | 1124416599 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: GA CHIR009377) |
Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: FL CH11740) |
Enumeration Date | 2015-01-07 |
Last Update Date | 2016-10-20 |