NPI | 1457411084 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: NY X009273) |
Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: CA 26290) |
Enumeration Date | 2006-12-12 |
Last Update Date | 2007-07-08 |