| NPI | 1619348448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 3047) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 20022) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2023-02-03 |