| NPI | 1811319825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: CA 20210) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: OK 4131) |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2014-01-09 |