| NPI | 1841652161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CHR.0007425) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 0007425) |
| 111NR0400X (Licence: CO CHR.0007425) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: CO CHR.0007425) | |
| 225000000X Orthotic Fitter (Licence: CO CHR.0007425) | |
| 225100000X Physical Therapist (Licence: CO CHR.0007425) | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2021-04-28 |