| NPI | 1538533393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: IA 004782) |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2022-03-08 |