| NPI | 1255819751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: CO CHR.0007870) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CHR.0007870) |
| 111NR0400X (Licence: CO CHR.0007870) | |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2018-08-06 |