| NPI | 1548484116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: NM 2697 MASSAGE) |
| Additional Taxonomies | 175L00000X Homeopath |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: NM 3867) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |