| NPI | 1093607186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: HI mae-18063) |
| Additional Taxonomies | 174400000X Specialist |
| 225700000X Massage Therapist | |
| Enumeration Date | 2025-07-15 |
| Last Update Date | 2025-07-15 |