| NPI | 1417917535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 13417) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 13417) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2023-01-31 |