| NPI | 1366229338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 5088) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ MT-26563) |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2025-06-12 |