| NPI | 1710355235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: ID ACC-89) |
| 225700000X Massage Therapist (Licence: ID MASG-354) | |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |