| NPI | 1437311701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038008088) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MI 2301401202) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2024-06-13 |