| NPI | 1770265175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: GA 010937) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: FL 14367) |
| Enumeration Date | 2023-08-04 |
| Last Update Date | 2023-08-04 |