| NPI | 1134491368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: TX 7247) |
| Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: TX 7247) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |