| NPI | 1275607814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA 1314) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA 2547) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-12-07 |