| NPI | 1043359169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT00000600) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00011128) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |