| NPI | 1134842164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 4471) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC214468) |
| 225700000X Massage Therapist (Licence: OR 24464) | |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2026-06-23 |