| NPI | 1184903098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA5412) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC0000761) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2014-12-10 |