| NPI | 1710019211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 1002) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: AZ 12-1319) |
| Enumeration Date | 2007-03-10 |
| Last Update Date | 2019-01-17 |