| NPI | 1508998170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: IL 038-006760) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: IL 038-006760) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2019-06-11 |