NPI | 1346605318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: MD M05495) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 198410) |
225700000X Massage Therapist (Licence: NC 01053) | |
Enumeration Date | 2015-12-17 |
Last Update Date | 2015-12-17 |