| NPI | 1902980212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: SC 2535) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: SC sc002535) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2017-10-05 |