| NPI | 1528408291 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 1893) | 
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC157837) | 
| Enumeration Date | 2013-06-26 | 
| Last Update Date | 2024-05-06 |