NPI | 1154136893 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: CA 751715) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 84076) |
Enumeration Date | 2025-02-10 |
Last Update Date | 2025-02-10 |