| NPI | 1265639462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: TX 10667) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 10667) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2018-02-27 |