| NPI | 1326271222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN1001X Chiropractor Nutrition (Licence: NM 1673) |
| Additional Taxonomies | 111NX0100X Chiropractor Occupational Health (Licence: NM 1673) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2009-08-26 |