| NPI | 1043498934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TN RCR0000000082) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: TN ND) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2012-05-21 |