| NPI | 1679149173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: AL 3341) |
| Additional Taxonomies | 227800000X Respiratory Therapist, Certified |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2021-06-03 |