| NPI | 1437407608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 2496) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CHR.0006894) |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2016-08-06 |