| NPI | 1669546313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: IL 038007603) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: WI 4121012) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2007-07-08 |