| NPI | 1992009435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 10-1226) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 7692) |
| Enumeration Date | 2010-12-24 |
| Last Update Date | 2021-04-12 |