| NPI | 1346595410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: SC 3754) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: SC 3754) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2023-09-11 |