| NPI | 1164548392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: IL 164004082) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198000209) |
| 172P00000X Naprapath (Licence: IL 181000198) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2007-07-08 |