| NPI | 1235596156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: GA CHIR009638) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR0099638) |
| 111NI0900X Chiropractor, Internist (Licence: GA CHIR009638) | |
| 111NN0400X Chiropractor, Neurology (Licence: GA CHIR009638) | |
| 111NR0200X Chiropractor, Radiology (Licence: GA CHIR009638) | |
| 111NR0400X Chiropractor, Rehabilitation (Licence: GA CHIR009638) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: GA CHIR009638) | |
| 111NX0100X Chiropractor, Occupational Health (Licence: GA CHIR009638) | |
| 111NX0800X Chiropractor, Orthopedic (Licence: GA CHIR009638) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: CA 33704) | |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: CA 33704) | |
| 111NI0900X Chiropractor, Internist (Licence: CA 33704) | |
| 111NN0400X Chiropractor, Neurology (Licence: CA 33704) | |
| 111NX0800X Chiropractor, Orthopedic (Licence: CA 33704) | |
| 111NR0400X Chiropractor, Rehabilitation (Licence: CA 33704) | |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-09-19 |