| 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 |