NPI | 1770718330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR002929) |
Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: GA CHIR002929) |
111NR0400X Chiropractor, Rehabilitation (Licence: GA CHIR002929) | |
Enumeration Date | 2009-05-26 |
Last Update Date | 2021-01-20 |