| NPI | 1477093227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 28496) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2024-08-05 |