| NPI | 1134344492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 0405) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: ID 1330) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2021-05-24 |