NPI | 1326652884 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist |
Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: FL MA51576) |
2255A2300X Specialist/Technologist, Athletic Trainer | |
Enumeration Date | 2020-09-02 |
Last Update Date | 2020-09-02 |