| NPI | 1033289335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: IL 038-006950) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038-006950) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2013-04-04 |