| NPI | 1730503152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: DE L1-0075765) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: DE MT-0002855) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2026-07-08 |