| NPI | 1437695608 |
|---|---|
| Other Name | JUAN GOMEZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT2995) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT039669) |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2017-01-12 |