NPI | 1831644327 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2301010549) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038.012977) |
Enumeration Date | 2016-08-24 |
Last Update Date | 2021-07-02 |