NPI | 1932625092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 13573) |
Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: TX 13573) |
111NR0400X Chiropractor, Rehabilitation (Licence: TX 13573) | |
Enumeration Date | 2017-08-20 |
Last Update Date | 2018-04-16 |