| NPI | 1942690151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 15-1489) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: VT 099.0107564) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2017-04-28 |