| NPI | 1588984868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA 54762) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA54762) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2010-06-09 |