NPI | 1821038753 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-006888) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: AZ 5237) |
Enumeration Date | 2006-06-08 |
Last Update Date | 2011-09-09 |