| NPI | 1043369952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: TX 8857) |
| Additional Taxonomies | 111NX0100X Chiropractor Occupational Health (Licence: TX 8857) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2008-04-23 |