| NPI | 1679005599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MS R855938) |
| Additional Taxonomies | 175F00000X Naturopath |
| 163WG0000X Registered Nurse, General Practice (Licence: TX 1036322) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2024-10-15 |