NPI | 1326488461 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: CO MT0014602) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CO 0330922) |
Enumeration Date | 2013-07-03 |
Last Update Date | 2013-07-03 |