| NPI | 1295147502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT60710043) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60428631) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2019-04-27 |