| NPI | 1548399801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IL 164004042) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 181.000136) |
| 172P00000X Naprapath (Licence: IL 181000136) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2025-09-11 |