| NPI | 1104958115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: CA ND1020) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NM 791Rx2) |
| 175F00000X Naturopath (Licence: WA NT1359) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2018-10-23 |