| NPI | 1427758713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X |
| Additional Taxonomies | 174H00000X Health Educator |
| 221700000X Art Therapist | |
| 225700000X Massage Therapist | |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-03-06 |