| NPI | 1104033588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 8717) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: TX 8717) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |