| NPI | 1245653955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CA 4668) |
| Additional Taxonomies | 173C00000X Reflexologist |
| 175L00000X Homeopath | |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2015-01-06 |