NPI | 1356151989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 28734) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200840875RN) |
Enumeration Date | 2025-01-07 |
Last Update Date | 2025-01-07 |