| NPI | 1780334425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: TX 14854) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: TX 14854) |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2022-03-25 |