| NPI | 1770909442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 12679) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 007106) |
| 111N00000X Chiropractor (Licence: TX 12679) | |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2023-03-02 |