| NPI | 1073638177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT00001520) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00013915) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2014-04-25 |