| NPI | 1346562923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CH0007956) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CO 9718) |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2024-04-17 |