NPI | 1982908141 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: UT 8233971-1202) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038011822) |
Enumeration Date | 2011-01-03 |
Last Update Date | 2012-11-19 |