| NPI | 1538426978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR THW0941) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: OR 11568) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2016-08-29 |