| NPI | 1578903928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: OH 401045210210) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: OH 287184505) |
| Enumeration Date | 2013-06-30 |
| Last Update Date | 2025-06-03 |