| NPI | 1609925437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: TX DC8668) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 8668) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2024-02-21 |