| NPI | 1447583901 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 111NX0100X Chiropractor, Occupational Health (Licence: CO 008068)  | 
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: IL 038006730)  | 
| Enumeration Date | 2009-09-15 | 
| Last Update Date | 2020-12-16 |