NPI | 1598876492 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 4841) |
Additional Taxonomies | 111NR0400X (Licence: TX 4841) |
111NS0005X Chiropractor, Sports Physician (Licence: TX 4841) | |
Enumeration Date | 2006-08-31 |
Last Update Date | 2007-07-08 |