| NPI | 1730598244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175L00000X Homeopath |
| Additional Taxonomies | 175F00000X Naturopath |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant | |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2017-04-06 |