| NPI | 1528154879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 181-000216) |
| Additional Taxonomies | 172P00000X Naprapath (Licence: IL 181-000216) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-08 |