| NPI | 1659790640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT60701877) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA 60345961) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2018-09-10 |