| NPI | 1215000898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 8788) |
| Additional Taxonomies | 246ZE0500X Specialist/Technologist, Other EEG |
| 246ZE0600X Specialist/Technologist, Other Electroneurodiagnostic | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2019-10-01 |