| NPI | 1982732368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60178142) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: WA NT00001426) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2019-01-11 |