| NPI | 1831425339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 5166) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: ND 335) |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2009-10-19 |