| NPI | 1073845525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN1001X Chiropractor Nutrition (Licence: MA 3532) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: MA 3868) |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2020-07-28 |