| NPI | 1568092252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CHR.0008166) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO EL.2787092) |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2021-08-28 |