| NPI | 1568471829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: CA ND693) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2055020) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2015-02-11 |