| NPI | 1154871622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: VT 099.0134145) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: OR 4025) |
| 175F00000X Naturopath (Licence: MA 0004) | |
| 175F00000X Naturopath (Licence: NH 0065) | |
| Enumeration Date | 2016-10-09 |
| Last Update Date | 2023-05-12 |