NPI | 1033479779 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 12058) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 12058) |
Enumeration Date | 2012-05-28 |
Last Update Date | 2014-05-16 |