| NPI | 1841373941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125.080018) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038-010493) |
| 207Q00000X Family Medicine (Licence: IL 125080018) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2023-11-02 |