| NPI | 1467719690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CH89002683) |
| Additional Taxonomies | 111NX0100X Chiropractor Occupational Health (Licence: GA CH89002683) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-04-12 |