| NPI | 1720125305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: TX 774910) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 8026) |
| 111NN0400X Chiropractor, Neurology (Licence: TX 8026) | |
| 111NR0400X Chiropractor, Rehabilitation (Licence: TX 8026) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2014-08-22 |