| NPI | 1144515404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME177138) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: AL 848) |
| 175F00000X Naturopath (Licence: NC 400055963) | |
| 164X00000X Licensed Vocational Nurse (Licence: CA VN191397) | |
| 174H00000X Health Educator (Licence: CA DSD2604) | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2025-11-17 |