NPI | 1801017405 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: IL 03804476) |
Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: IL 03804476) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2009-02-17 |