| NPI | 1861568610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA chir005241) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: GA 000207) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2024-08-12 |