NPI | 1073905345 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 121213) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038012768) |
Enumeration Date | 2015-02-24 |
Last Update Date | 2024-05-13 |