| NPI | 1447791371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 43130) |
| 283X00000X Rehabilitation Hospital (Licence: CA 43130) | |
| 111N00000X Chiropractor (Licence: CA 43130) | |
| 171100000X Acupuncturist (Licence: CA 43130) | |
| 282N00000X General Acute Care Hospital (Licence: CA 43130) | |
| Enumeration Date | 2017-03-11 |
| Last Update Date | 2023-10-04 |