NPI | 1508878463 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: CO 2788) |
Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: CO 2788) |
Enumeration Date | 2006-08-12 |
Last Update Date | 2011-03-22 |