| NPI | 1376622829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 1188) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 273128) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2011-10-10 |