| NPI | 1538725692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 0008028) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CHR.008028) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2023-10-26 |