| NPI | 1811002934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: IL 038-004280) |
| Additional Taxonomies | 111NI0900X Chiropractor, Internist (Licence: IL 038-004280) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2025-09-11 |