| NPI | 1952550675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: CA ND711) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52369) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2016-09-01 |