| NPI | 1164541389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: DC NAT1000019) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ RI01899700) |
| 183500000X Pharmacist (Licence: FL PS22834) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |