| NPI | 1871670588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: OR 271359) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: 10333348) |
| 133NN1002X Nutritionist Nutrition, Education | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |