| NPI | 1447258579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 09918) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 9918) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2023-12-19 |