| NPI | 1770854945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA 60724447) |
| Additional Taxonomies | 111NI0900X Chiropractor, Internist (Licence: IL 038008039) |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2019-01-29 |