| NPI | 1194296442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CHR.0007852) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: CO CHR.0007852) |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2020-10-13 |