| NPI | 1578577672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: CA ND-161) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 14919) |
| 363A00000X Physician Assistant (Licence: CA PA-14919) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2010-11-11 |