NPI | 1093005191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: DC MT124) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: VA 0019002576) |
Enumeration Date | 2011-04-11 |
Last Update Date | 2011-04-14 |