| NPI | 1891078275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: CA ND-457) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WI 10900-146) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-09-22 |