| NPI | 1972938405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: OH 4266) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038012506) |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2016-08-11 |