| NPI | 1689113896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NJ 18KT01276600) |
| Additional Taxonomies | 133N00000X Nutritionist |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 172M00000X Mechanotherapist | |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2019-10-28 |