| NPI | 1396137816 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: IL 038012763)  | 
| Additional Taxonomies | 175F00000X Naturopath (Licence: WA NT60832386)  | 
| Enumeration Date | 2015-02-19 | 
| Last Update Date | 2022-11-28 |