| NPI | 1740298157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NI0900X Chiropractor, Internist (Licence: IL 038009161) |
| Additional Taxonomies | 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: IL 038009161) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2019-06-24 |