NPI | 1720693286 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: FL Ma83138) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: ma83138) |
Enumeration Date | 2020-09-11 |
Last Update Date | 2020-09-11 |