| NPI | 1053808162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 171624) |
| Additional Taxonomies | 133VN1005X Dietitian, Registered, Nutrition, Renal (Licence: AL 870274) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2019-10-02 |