| NPI | 1689952251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 6099) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CHR.0006099) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2023-10-12 |