| NPI | 1225083322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 7101) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: TX 7101) |
| 207R00000X Internal Medicine (Licence: NM DC2211) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2024-01-30 |