| NPI | 1245235589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 7906) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: TX 7906) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2023-03-29 |