NPI | 1700921905 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225700000X Massage Therapist (Licence: TX MT016991) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX DC 6385) |
Enumeration Date | 2007-02-21 |
Last Update Date | 2025-09-11 |