| NPI | 1346397080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 10235) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: TX 10235) |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: TX 10235) | |
| 111NX0100X Chiropractor, Occupational Health (Licence: TX 10235) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2021-12-14 |