| NPI | 1376754168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA 903) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U01995) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2016-11-06 |