NPI | 1720560618 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: CA 75895) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: NV 10475) |
Enumeration Date | 2018-09-06 |
Last Update Date | 2022-07-14 |