| NPI | 1295702959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA 44245) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL ma44245) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2007-07-08 |