| NPI | 1336254069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CHR.0008498) |
| Additional Taxonomies | 111NN1001X Chiropractor Nutrition (Licence: CO CHR.0008498) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2024-08-04 |