| NPI | 1245248400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 4867) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 111NN0400X Chiropractor, Neurology (Licence: CO 4867) | |
| 111NN1001X Chiropractor, Nutrition (Licence: CO 4867) | |
| 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: CO 4867) | |
| 111NR0200X Chiropractor, Radiology (Licence: CO 4867) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: CO 4867) | |
| 111NX0100X Chiropractor, Occupational Health (Licence: CO 4867) | |
| 111NX0800X Chiropractor, Orthopedic (Licence: CO 4867) | |
| 111NR0400X (Licence: CO 4867) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-03-17 |