| NPI | 1982644654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: CO 5504) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 5504) |
| 111N00000X Chiropractor (Licence: VA 0104556195) | |
| 111N00000X Chiropractor (Licence: TX 7231) | |
| 111NX0100X Chiropractor Occupational Health (Licence: TX 7231) | |
| 111NR0400X Chiropractor Rehabilitation (Licence: TX 7231) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2015-06-10 |