NPI | 1669246971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 15799) |
Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: TX 15799) |
Enumeration Date | 2023-11-08 |
Last Update Date | 2025-05-01 |