| NPI | 1760838379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT60894146) |
| Additional Taxonomies | 175F00000X Naturopath |
| 225700000X Massage Therapist (Licence: WA MA60600545) | |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2019-05-15 |