NPI | 1184720229 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 5921) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CHR0006933) |
111N00000X Chiropractor (Licence: IL 038-007339) | |
Enumeration Date | 2006-09-16 |
Last Update Date | 2021-01-12 |