NPI | 1174368294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT007703) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: SC 7830) |
Enumeration Date | 2024-06-29 |
Last Update Date | 2024-06-29 |