| NPI | 1154869642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: CO CHR.0007530) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 0007530) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2023-04-17 |