| NPI | 1295004208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: TX 9240) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: OK 3749) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2025-08-22 |