| NPI | 1013427905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 174H00000X Health Educator | |
| 175F00000X Naturopath | |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2018-11-13 |