| NPI | 1730234170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NX0100X Chiropractor, Occupational Health (Licence: TX 6746) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 6746) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2013-10-03 |