| NPI | 1356763494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT60434716) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC60436859) |
| 225700000X Massage Therapist (Licence: WA MA60172195) | |
| 225700000X Massage Therapist (Licence: IA 03471) | |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2014-01-08 |