| NPI | 1780825471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 1520) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CT 669) |
| 171100000X Acupuncturist (Licence: OR AC150791) | |
| 171100000X Acupuncturist (Licence: NY 5723) | |
| 175F00000X Naturopath (Licence: CT 562) | |
| Enumeration Date | 2009-03-10 |
| Last Update Date | 2022-03-22 |