| NPI | 1831433481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0200X Chiropractor, Radiology (Licence: IL 038011371) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038011371) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2014-06-04 |