| NPI | 1437574258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: TX 12428) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: GA CHIR009098) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2014-03-03 |