| NPI | 1164670840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA 680) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: CA 220) |
| 183500000X Pharmacist (Licence: NY 037945) | |
| 183500000X Pharmacist (Licence: WA 15468) | |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2016-01-05 |