| NPI | 1306396692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT60720905) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC179544) |
| 171100000X Acupuncturist (Licence: WA AC60720897) | |
| 175F00000X Naturopath (Licence: OR 4013) | |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2022-07-23 |