| NPI | 1336889914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: PR 000163) |
| Additional Taxonomies | 171400000X Health & Wellness Coach (Licence: PR 1978-10981208) |
| 171400000X Health & Wellness Coach (Licence: PR 1978-13000208) | |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-03-31 |