NPI | 1497417075 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225700000X Massage Therapist (Licence: CT 10425) |
Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: CT 2173) |
225700000X Massage Therapist (Licence: MA 16732) | |
Enumeration Date | 2021-10-11 |
Last Update Date | 2021-10-11 |