| NPI | 1639506710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 13-1376) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH 66.000031) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2018-02-20 |