| NPI | 1619627759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 5133) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 6224) |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2026-08-06 |