NPI | 1356445092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: TX 8225) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 8225) |
111NS0005X Chiropractor, Sports Physician (Licence: TX 8225) | |
Enumeration Date | 2006-09-12 |
Last Update Date | 2008-06-26 |