| NPI | 1558191031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA75245) |
| Additional Taxonomies | 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: PR 38987A) |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-08-07 |