| NPI | 1568028504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202D00000X Integrative Medicine (Licence: VT 099.0134146) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: CA ND1072) |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2023-08-02 |