NPI | 1295835445 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038008978) |
Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: IL 038-008978) |
Enumeration Date | 2006-09-25 |
Last Update Date | 2023-07-12 |