NPI | 1508559683 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: IL 038.013992) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038.013992) |
Enumeration Date | 2023-06-02 |
Last Update Date | 2023-06-02 |