| NPI | 1841462306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038006543) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198000118) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2011-10-04 |