| NPI | 1518940386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202D00000X (Licence: IA NA) |
| Additional Taxonomies | 111NN1001X Chiropractor Nutrition (Licence: IA 06258) |
| 175F00000X Naturopath (Licence: IA NA) | |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2024-08-14 |