| NPI | 1447314422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KS 01-03367) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 5222) |
| 111N00000X Chiropractor (Licence: MO 004001) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2010-06-15 |