| NPI | 1285773614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172P00000X Naprapath (Licence: NM 0016) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 181-000293) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2010-07-19 |