| NPI | 1285703710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: WI 4264-12) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: IL 038-010349) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2018-06-15 |