| NPI | 1679883649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL 45141) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: FL 45141) |
| 173C00000X Reflexologist (Licence: FL 45141) | |
| 174400000X Specialist (Licence: FL 45141) | |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2010-10-08 |