| NPI | 1447884952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 5111) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 24406) |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2025-10-24 |