| NPI | 1982738423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: IL 198-000-877) |
| Additional Taxonomies | 172P00000X Naprapath (Licence: IL 181000280) |
| 174400000X Specialist (Licence: IL 181000280) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2019-03-07 |