| NPI | 1013673037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: HI 16697) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: HI H0158935) |
| Enumeration Date | 2021-11-14 |
| Last Update Date | 2021-11-14 |