| NPI | 1568603447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: NV B01047) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NV B01047) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2009-03-23 |