NPI | 1427245984 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR008162) |
Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: GA CHIR008162) |
111NX0800X Chiropractor, Orthopedic (Licence: GA CHIR008162) | |
111NR0400X (Licence: GA CHIR008162) | |
Enumeration Date | 2007-09-28 |
Last Update Date | 2011-06-21 |