NPI | 1326085036 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX DC2246) |
Additional Taxonomies | 111NR0400X Chiropractor Rehabilitation (Licence: TX DC2246) |
Enumeration Date | 2006-06-01 |
Last Update Date | 2020-12-09 |