| NPI | 1306992698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61279914) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: CA 212) |
| 175F00000X Naturopath (Licence: WA NT00001528) | |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2022-03-15 |