| NPI | 1508048794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT00001607) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC00003060) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2012-03-07 |