| NPI | 1306377692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CHR.0007588) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 7588) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-07-25 |