| NPI | 1093741878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 6250) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO 2772062) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2019-04-01 |