| NPI | 1225464241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: NH 930) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MA CH1699) |
| 111NN1001X Chiropractor, Nutrition (Licence: MA CH1699) | |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2014-03-26 |