NPI | 1518971308 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR007051) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: GA 7051) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2020-12-11 |