| NPI | 1831313485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: TX 8914) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: TX 8914) |
| 111NR0400X Chiropractor, Rehabilitation (Licence: TX 8914) | |
| 111NX0800X Chiropractor, Orthopedic (Licence: TX 8914) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2007-10-26 |