NPI | 1396851457 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 8128) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038009830) |
Enumeration Date | 2006-08-22 |
Last Update Date | 2022-12-30 |