| NPI | 1720170970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO NP-990132) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CHR-6637) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2016-01-22 |