| NPI | 1245370048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-006335) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198-000392) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2007-07-08 |