| NPI | 1063423234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038006449) |
| Additional Taxonomies | 171100000X Acupuncturist |
| 175L00000X Homeopath | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2009-08-09 |