| NPI | 1396876348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: IL 038008219) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: IL 038008219) |
| 111NR0400X Chiropractor, Rehabilitation (Licence: IL 038008219) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: IL 038008219) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2025-09-11 |