| 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 |