NPI | 1518237296 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA 00017830) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: NV 557) |
Enumeration Date | 2012-01-11 |
Last Update Date | 2012-01-11 |