NPI | 1033168307 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038008006) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 2682) |
Enumeration Date | 2006-05-06 |
Last Update Date | 2022-08-25 |