| NPI | 1376877415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM1400X Registered Nurse Nurse Massage Therapist (NMT) (Licence: OH 178178) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OH 33007573) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2009-09-22 |