| NPI | 1952602310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: CO 6554) |
| Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: CO 6554) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |