| NPI | 1902094386 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 0362ND.) | 
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 1232-DC) | 
| 175F00000X Naturopath (Licence: OR 362-ND) | |
| Enumeration Date | 2007-10-10 | 
| Last Update Date | 2021-05-06 |