| NPI | 1073707808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MD R00702) |
| Additional Taxonomies | 1744R1103X Specialist, Research Data Abstracter/Coder (Licence: MD 2003140) |
| 225700000X Massage Therapist (Licence: DC MT1014) | |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2007-09-05 |