| NPI | 1437361292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 8945) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 8945) |
| 111NS0005X Chiropractor, Sports Physician (Licence: TX 8945) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2008-08-20 |