| NPI | 1164029542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NY 028398) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: NY 028398) |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |