| NPI | 1326104886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR002810) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA GACHIR002810) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2021-08-02 |