| NPI | 1790939601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 1583) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 009236) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2008-11-06 |