| NPI | 1225185606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 08487) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 8487) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2025-05-05 |