| NPI | 1891756664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-007635) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038007635) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2023-07-04 |