| 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 |