| NPI | 1992932206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 09-1121) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: AZ 09-1121) |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2023-01-26 |