| NPI | 1124662887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 4306) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 23604) |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2021-03-30 |