| NPI | 1629471701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 4040) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC179406) |
| 175F00000X Naturopath (Licence: AZ 14-1453) | |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2018-06-01 |