NPI | 1194195032 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2004844) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: OH 022335) |
Enumeration Date | 2015-10-05 |
Last Update Date | 2020-05-28 |