NPI | 1285703710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: WI 4264-12) |
Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: IL 038-010349) |
Enumeration Date | 2006-11-07 |
Last Update Date | 2018-06-15 |