| NPI | 1538308317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: TX 2888) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 2888) |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2009-10-06 |