| NPI | 1699113001 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: 021029) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: OH 33.021029) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2013-08-15 |