| NPI | 1891883088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA 005252) |
| Additional Taxonomies | 111NN0400X Chiropractor Neurology (Licence: GA 005252) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-07-28 |