NPI | 1538254123 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038.006626) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038006626) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2021-01-12 |