| NPI | 1427486778 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 175F00000X Naturopath | 
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy | 
| 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician | |
| 367H00000X Anesthesiologist Assistant | |
| 174H00000X Health Educator | |
| 1710I1002X Military Health Care Provider, Independent Duty Corpsman | |
| 172A00000X Driver | |
| 175L00000X Homeopath | |
| Enumeration Date | 2013-10-24 | 
| Last Update Date | 2016-01-05 |