| NPI | 1366683690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: IL 038011380) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038011380) |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2018-08-20 |