NPI | 1487953345 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 11658) |
Additional Taxonomies | 111NI0013X Chiropractor Independent Medical Examiner (Licence: TX 11658) |
111NN0400X Chiropractor Neurology (Licence: TX 11658) | |
111NN1001X Chiropractor Nutrition (Licence: TX 11658) | |
111NP0017X Chiropractor Pediatric Chiropractor (Licence: TX 11658) | |
111NR0200X Chiropractor Radiology (Licence: TX 11658) | |
111NR0400X Chiropractor Rehabilitation (Licence: TX 11658) | |
111NS0005X Chiropractor Sports Physician (Licence: TX 11658) | |
111NX0100X Chiropractor Occupational Health (Licence: TX 11658) | |
111NX0800X Chiropractor Orthopedic (Licence: TX 11658) | |
Enumeration Date | 2011-03-17 |
Last Update Date | 2016-01-07 |