| NPI | 1316339591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: LA La4496) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: LA 4496) |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2015-02-27 |