| NPI | 1811002074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX 0202) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: TX 0202) |
| 111NN1001X Chiropractor, Nutrition (Licence: TX 9211) | |
| 171100000X Acupuncturist (Licence: TX 0104) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2012-01-04 |