| NPI | 1275546053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 4077) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO 4077) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-09 |