NPI | 1053346700 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 5599) |
Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: TX 5599) |
Enumeration Date | 2006-07-11 |
Last Update Date | 2008-09-08 |