NPI | 1437329885 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038.011208) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2008001851) |
Enumeration Date | 2008-03-01 |
Last Update Date | 2015-07-21 |