| NPI | 1578656963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172P00000X Naprapath (Licence: IL 181-000307) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 181000307) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2017-11-01 |