| NPI | 1841261708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-009301) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 9125) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2020-02-05 |