| NPI | 1215781919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist |
| Additional Taxonomies | 173C00000X Reflexologist |
| 207N00000X Dermatology (Licence: MN 22045913) | |
| 225100000X Physical Therapist | |
| 225A00000X Music Therapist | |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |