| NPI | 1619489002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 4152) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC185398) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2018-04-13 |