| NPI | 1760579726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 1250) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC00002488) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2025-09-11 |