| NPI | 1548313679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA33269) |
| Additional Taxonomies | 227800000X Respiratory Therapist, Certified (Licence: FL TT8467) |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2007-07-08 |