| NPI | 1710748116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MD M06476) |
| Additional Taxonomies | 173C00000X Reflexologist |
| 374K00000X Religious Nonmedical Practitioner | |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-01-22 |