| NPI | 1528262946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT001492) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: GA MT001492) |
| 175F00000X Naturopath (Licence: GA MT001492) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2009-02-20 |