| NPI | 1669415428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-010359) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038010359) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2018-03-17 |