NPI | 1447207501 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX DC6197) |
Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: TX DC6197) |
Enumeration Date | 2006-05-27 |
Last Update Date | 2020-12-31 |