| NPI | 1194807495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 03-739) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: AZ 03739) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2022-07-21 |