| NPI | 1134547516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: TX MT119645) |
| Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: TX 548639) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2014-04-02 |