| NPI | 1225802093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: IL 227007700) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IN MT20901677) |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2023-11-13 |