| NPI | 1861389348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TN 3878) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 16403) |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2025-06-18 |