| NPI | 1285378000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TN 3771) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR011090) |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2024-02-03 |