| NPI | 1366890915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: GA CHIR009501) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: TX 13069) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |