| NPI | 1003948373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT00001033) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC00002439) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2018-03-23 |