| NPI | 1295589299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NY 033580) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NJ 18KT01309900) |
| Enumeration Date | 2024-04-16 |
| Last Update Date | 2024-04-25 |