| NPI | 1457363319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 03-716) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 3293) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2007-07-08 |