| NPI | 1235279548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NI0900X Chiropractor, Internist (Licence: IL 038004891) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: IL 038004891) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2009-04-06 |