| NPI | 1104210053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT00001298) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 002612-1) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2023-05-26 |