| NPI | 1306098371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: TX 14090) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OToooo2375) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2019-06-11 |