Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 099.0134102 | VT |
NPI | 1104467760 |
---|---|
Provider Name | Dr. Michael Robinson |
First Address | Bolingbrook, IL 60440-1923 |
Second Address | Downers Grove, IL 60515-4602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2019 |
Last Update Date | 24/02/2020 |