| NPI | 1346753605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 4449) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC210340) |
| 225700000X Massage Therapist (Licence: OR 22773) | |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2022-11-07 |