NPI | 1033436738 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038011897) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TN 2425) |
Enumeration Date | 2010-04-21 |
Last Update Date | 2011-03-11 |