| NPI | 1023455920 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 175F00000X Naturopath (Licence: UT 10168563-7100) | 
| Additional Taxonomies | 175F00000X Naturopath (Licence: OR 1951) | 
| 175F00000X Naturopath (Licence: UT 10168563-8919) | |
| Enumeration Date | 2013-05-31 | 
| Last Update Date | 2022-01-12 |