| NPI | 1700361300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath |
| Additional Taxonomies | 175L00000X Homeopath |
| 225100000X Physical Therapist | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2018-09-28 |