| NPI | 1295170322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: CO MT.0001319) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO ACU.0002542) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2019-12-19 |