| NPI | 1992921969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 13824) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC7872) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-10-02 |