| NPI | 1437877529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KS 01-06200) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038.013878) |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2022-08-16 |