| NPI | 1174931141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038.012654) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: IL 038.012654) |
| 111NX0800X Chiropractor, Orthopedic (Licence: IL 038.012654) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: IL 038.012654) | |
| 171100000X Acupuncturist (Licence: NJ 25MZ00179500) | |
| 111N00000X Chiropractor (Licence: NJ 38MC00736000) | |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2025-11-06 |