| NPI | 1124026307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 09-1105) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AZ 5710) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2009-04-06 |