| NPI | 1447564497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 6697) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC-31371) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2013-05-29 |