| NPI | 1497933154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 03-744) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AZ 03-744) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2023-05-10 |