NPI | 1780346924 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: GA 009965) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL 12328) |
Enumeration Date | 2021-10-05 |
Last Update Date | 2021-10-05 |