| NPI | 1902887813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 460) |
| Additional Taxonomies | 2471S1302X Radiologic Technologist, Sonography (Licence: OR 02315) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2023-03-07 |