| NPI | 1467661702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: TX DC2610) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: FL CH 3157) |
| 111NN1001X Chiropractor, Nutrition (Licence: OK 3238) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |