| NPI | 1659511012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172M00000X Mechanotherapist |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 225700000X Massage Therapist (Licence: IN MT20902052) | |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2025-11-27 |