| NPI | 1861452856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-009488) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038009488) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2009-01-28 |