| NPI | 1093853939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172P00000X Naprapath (Licence: NM 0001) |
| Additional Taxonomies | 172P00000X Naprapath (Licence: IL 181000111) |
| 174400000X Specialist (Licence: IL 181.000111) | |
| 174400000X Specialist (Licence: NM 0001) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2018-01-25 |