| NPI | 1992824247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 14542) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC29171) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2021-09-09 |