| NPI | 1225329113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2011-04-26 |