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