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 |