NPI | 1518725258 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 27935) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ 24206) |
Enumeration Date | 2024-03-07 |
Last Update Date | 2024-03-07 |