| NPI | 1831306943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X (Licence: CO 6034) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: CO 6034) |
| 111NT0100X Chiropractor, Thermography (Licence: CO 6034) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-10 |