| NPI | 1679659072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172P00000X Naprapath (Licence: IL 181000295) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149000523) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-07-08 |