| NPI | 1275943987 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 14-1434) | 
| Additional Taxonomies | 175F00000X Naturopath (Licence: VT 099.0102679) | 
| Enumeration Date | 2014-05-02 | 
| Last Update Date | 2014-05-02 |