| NPI | 1144381948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: IL 038009628) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH11436) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2019-09-24 |