| NPI | 1568548857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-007500) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: IL 038-007500) |
| Enumeration Date | 2006-10-28 |
| Last Update Date | 2007-07-08 |