NPI | 1659559821 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AR 16088) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038.011129) |
Enumeration Date | 2008-02-09 |
Last Update Date | 2020-12-29 |