| NPI | 1417975897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CHR.0007121) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO AC.2786112) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2022-10-05 |