| NPI | 1841362829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: IL 038008505) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: IL 038.008505) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2019-04-04 |