NPI | 1679256267 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-NLEIGK) |
Additional Taxonomies | 174400000X Specialist (Licence: CA HT723100) |
225700000X Massage Therapist (Licence: CA 82448) | |
Enumeration Date | 2023-08-09 |
Last Update Date | 2024-07-10 |