| NPI | 1326111352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: TX 9053) |
| Additional Taxonomies | 111NR0400X (Licence: TX 9053) |
| 111NX0100X Chiropractor, Occupational Health (Licence: TX 9053) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2024-03-04 |