| NPI | 1427287713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CHR.0006476) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AZ 9157) |
| 111N00000X Chiropractor (Licence: WA CH60092039) | |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2024-04-15 |