| NPI | 1003326406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: MS 732032) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 208D00000X General Practice (Licence: MS 732032) | |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2023-11-27 |