| NPI | 1043575301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: AZ MT-05220) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: AZ MT-05220) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2012-07-11 |