| NPI | 1033168307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038008006) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 2682) |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2022-08-25 |