| NPI | 1902949001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX DC6885) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: TX DC6885) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2024-01-25 |