NPI | 1932215498 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-009874) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2006003308) |
Enumeration Date | 2006-08-21 |
Last Update Date | 2011-03-25 |