| NPI | 1861415077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 08709) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 8709) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-02-27 |