NPI | 1932189289 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 4059DC) |
Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: TX 4059DC) |
111NX0100X Chiropractor, Occupational Health (Licence: TX 4059DC) | |
Enumeration Date | 2006-01-20 |
Last Update Date | 2007-07-08 |