| NPI | 1982848354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2008015781) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: MO 2008015781) |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2009-04-28 |