| NPI | 1043817513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA61266030) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: WA RF61100386) |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2022-06-28 |