| NPI | 1376157792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist |
| Additional Taxonomies | 225A00000X Music Therapist (Licence: CA 6760) |
| 225700000X Massage Therapist (Licence: CA 6760) | |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |