| NPI | 1790860476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: DE 111NN1001X) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: PA DC-007149-L) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2022-06-14 |