| NPI | 1245540244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: FL FL RN 1038922) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA 5079) |
| Enumeration Date | 2010-10-09 |
| Last Update Date | 2010-10-09 |