NPI | 1376768663 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111NR0400X (Licence: TX 8339) |
Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: TX 8339) |
Enumeration Date | 2007-04-13 |
Last Update Date | 2023-12-18 |