| NPI | 1851659361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B.01967) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038.012178) |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: IL 038.012178) | |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: NV B.01967) | |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2023-07-24 |