| NPI | 1659503738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA60082855) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC60102377) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2009-09-16 |