NPI | 1518245042 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 174400000X Specialist (Licence: CA 21935) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 21935) |
Enumeration Date | 2011-08-02 |
Last Update Date | 2024-01-28 |