| NPI | 1811200223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 7959) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 07959) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2025-06-02 |