| NPI | 1972647428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 911) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR 19322) |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2007-07-09 |