| NPI | 1437699857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: IL 227.019517) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MO 2014007249) |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2017-03-03 |