NPI | 1609991264 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: NM 424) |
Additional Taxonomies | 111NI0900X Chiropractor, Internist (Licence: NM 424) |
Enumeration Date | 2007-03-20 |
Last Update Date | 2008-02-02 |