| NPI | 1467570804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN1001X Chiropractor Nutrition (Licence: CA D.C0175130) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 17513) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2025-08-22 |