| NPI | 1962735217 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 1821) | 
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC150207) | 
| Enumeration Date | 2009-09-17 | 
| Last Update Date | 2024-08-12 |