| NPI | 1881834570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA NT60555235) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: WA NT60555235) |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2020-01-29 |