| NPI | 1730268889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-009932) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 0038-009932) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2014-05-13 |