| NPI | 1417084286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 4284) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038-008673) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2022-12-14 |