| NPI | 1003326588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B01783) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038013153) |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2024-05-28 |