| NPI | 1942389663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-010252) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038010252) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2019-02-12 |