| NPI | 1255688768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 19099) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: OR 19099) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2012-08-14 |