| NPI | 1639298086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175L00000X Homeopath (Licence: AZ 02-704) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: WA NT00000694) |
| 175F00000X Naturopath (Licence: AZ 02-704) | |
| 175L00000X Homeopath (Licence: WA NT00000694) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2025-09-11 |