| NPI | 1265503072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX DC8097) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: TX DC8097) |
| 133N00000X Nutritionist | |
| 175F00000X Naturopath | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |