| NPI | 1487986311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA00021698) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: WA MA00021698) |
| 174400000X Specialist (Licence: WA MA00021698) | |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-02-03 |