| NPI | 1134835135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CHR.0008735) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AR 16377) |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2024-03-20 |