| NPI | 1053340703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KS 01-04070) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: KS 01-04070) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2007-07-08 |