| NPI | 1538548730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR008082) |
| Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: GA CHIR008082) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |