| NPI | 1346269040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0100X Chiropractor Occupational Health (Licence: AL 2085) |
| Additional Taxonomies | 111NI0013X Chiropractor Independent Medical Examiner (Licence: AL 2085) |
| 111NR0400X Chiropractor Rehabilitation (Licence: AL 2085) | |
| 111NS0005X Chiropractor Sports Physician (Licence: AL 2085) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-07-10 |