| NPI | 1841771904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT60892302) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 100572) |
| 175F00000X Naturopath (Licence: AZ 20-1879) | |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2026-01-15 |