| NPI | 1992836845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 3992) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO 3992) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2012-04-04 |