| NPI | 1114172194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT60050283) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC60083605) |
| 171100000X Acupuncturist (Licence: TX AC01484) | |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2015-11-17 |