| NPI | 1497177703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OH 33.007750 H-K) |
| Additional Taxonomies | 174H00000X Health Educator |
| 363A00000X Physician Assistant | |
| 172M00000X Mechanotherapist | |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2014-12-19 |