| NPI | 1689450892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0100X Chiropractor, Occupational Health (Licence: FL 14676) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MS 1383) |
| Enumeration Date | 2023-09-04 |
| Last Update Date | 2024-02-21 |