| NPI | 1053331462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: CT 000352) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AZ 06917) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-01-18 |