| NPI | 1588873095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NH 3472M) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NH 0452) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2013-05-02 |