NPI | 1528175445 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA00024952) |
Additional Taxonomies | 225200000X Physical Therapy Assistant |
Enumeration Date | 2006-08-24 |
Last Update Date | 2023-03-20 |