| NPI | 1467510230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038010574) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC009376) |
| 111N00000X Chiropractor (Licence: MI 2301009397) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2008-03-31 |