| NPI | 1194132993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA60267132) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: WA MA60267132) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2014-07-14 |