| NPI | 1063545861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 292) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 11487) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2025-09-11 |