| NPI | 1235269432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X (Licence: TX 6064) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: TX 6064) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |