| NPI | 1215501572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: PR 4664) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: PR 244) |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2025-09-22 |