| NPI | 1952302549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: TX 8414) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 8414) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2025-09-03 |