NPI | 1619137643 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA 55891) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 017465) |
Enumeration Date | 2008-06-12 |
Last Update Date | 2010-03-12 |