| NPI | 1225641632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: CT 000393) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 008110) |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-25 |