NPI | 1760880603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-004048) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08000688A) |
Enumeration Date | 2014-12-09 |
Last Update Date | 2014-12-09 |